1 Does brain breaks have any effect on the motives of participation in PA among primary school children?
2 Does brain breaks have any effect on sustained attention among primary school children?
3 Does brain breaks have any effect on short-term memory among primary school children?
4 Does brain breaks have any effect on academic performance among primary school children?
8 CHAPTER 2 LITERATURE REVIEW 2.1 Physical activity
Physical activity is defined as any bodily movement produced by the skeletal muscles that requires energy expenditure, including activities undertaken while doing house chores, engaging in recreational activities and climbing stairs (WHO, 2017). This term differs from exercise as it is a subcategory of PA that is planned, structured, and aims to improve or maintain one or more components of physical fitness (WHO, 2015). Physical inactivity is claimed to be the leading cause of hypertensive illness and is estimated to cause two million deaths per year (WHO, 2015). Over the past three decades, the number of people with diabetes mellitus has increased more than doubled globally (Chen, Magliano, & Zimmet, 2012). Worldwide prevalence of overweight and obesity has risen to 39% and 13%
respectively in almost the same amount of time (WHO, 2016).
Overweight and obesity are defined as having abnormal or excessive fat accumulation that presents a risk to health (WHO, 2016). A cross-sectional study by Trost, Kerr, Ward, and Pate (2001) pertaining to physical inactivity found that most obese children in a district in the United States spend less time in both moderate and vigorous PA compared to non-obese children. In addition, a study by Epstein et al. (2002) found that television viewing promoted weight gain and increase energy intake as this activity displaced PA among children. The author further added that there is a direct relationship between physical inactivity and media viewing; resulting in increased complication risks and non-communicable diseases such as hypertension, diabetes mellitus and heart disease. WHO (2016) estimated that nearly half of the 41 million children under the age of five living in
9
Asia are overweight and obese. Furthermore, a meta-analysis studying the health consequences of childhood obesity found various type of health risks including psychological consequences especially among girls, developing asthma symptom, cardiovascular risk factor in childhood, increase risk in Type 1 diabetes, low grade of systemic inflammation, and abnormalities in foot structure (Reilly et al., 2003).
The relationship between regular PA and psychological and physical health has been thoroughly established in past studies (Butt, Weinberg, Breckon, & Claytor, 2011). The takeaway message is that regular PA provides essential health benefits, one of which is the reduction of non-communicable diseases and reduction of mortality rate (Celis-Morales et al., 2012; Williams, 2012). In addition, regular PA could contribute to increased mental health and academic performance, lower stress and depression levels (Rasberry et al., 2011), demonstrated improvement in mathematics skills, cognitive flexibility, improved memory and creativity when engaged in sufficient PA such as aerobic exercise (Chaddock, Pontifex, Hillman, & Kramer, 2011; Hillman, Erickson, & Kramer, 2008).
Nonetheless, in Malaysia, people are not active enough to take advantage of the health benefits provided by regular PA; rather, are living a sedentary lifestyle (Poh et al., 2010). Furthermore, individuals who were physically inactive during adolescence are more likely to be inactive in their adulthood (Gordon-Larsen, Adair, Nelson, & Popkin, 2004). For these reasons, researchers, health professionals, and policymakers have all sought to explore why some people are physically active, whereas others are not (Molanorouzi, Khoo, &
Morris, 2014). Although the factors for participating in regular PA is highly complex, studies have pointed out motivation as a driving factor not only for PA participation, but also for its adherence (Aaltonen et al., 2012; André & Dishman, 2012).
10 2.2 Brain breaks
Children spend most of their time in the school environment. Therefore, by implementing PA intervention in the school environment could be an ideal way. However, putting too much stress on academic performance, lack of school leadership support, lack of resources, and poor teaching quality are barriers to promote PA in school (Hills et al., 2015). As a solution, the GCH foundation suggests Brain Breaks® PA Solutions by HOPSports® as an intervention to promote PA among participants during school days. The aim of the intervention is to expand the successful implementation of globally recognised, evidence-based health and wellness programs in their communities while respecting local culture and customs (Uzunoz et al., 2017). Brain breaks is a web-based structured PA breaks with duration of two to five minutes designed for classroom setting (GCH foundation, 2017). In addition, brain breaks can be used to educate and empower children to become the premier agents of change, guiding them to create, share and practice health strategies and transform and improve the quality of life for others and themselves (Uzunoz et al., 2017).
The GCH foundation uses the WSCC (Whole School, Whole Community, Whole Child) model as a framework (Lewallen, Hunt, Potts‐Datema, Zaza, & Giles, 2015). It helps teachers to have an instant additional resource tool to revitalise the classroom environment and activate participants’ learning. Moreover, it helps to improve test scores and fulfil mandates for increased PA nutrition education without compromising valuable instructional time (HOPSports®, 2017). Using this application indirectly attracts children to engage in PA without waiving their interest towards internet-based and video technology. This PA intervention, which was introduced by HOPSports, is used to motivate participants to enhance their theoretical lessons and provide opportunity not only to be physically active
11
during breaks, but also learn new motor skills, language, art, music and different cultures (Chin, Edginton, & Tang, 2013).
The programme is supported by the United Nations as part of the 17 Sustainable Developmental Goals under the goals of good health and well-being (Kuan, Rizal, Hajar, Chin, & Mok, 2019). To access the resource (https://brain-breaks.com/), users only required an internet connection and a projector to display the PA videos. More studies are needed in identifying the motives of younger people for participating and/or abstaining from PA to alter the increasing trend of physical inactivity among youth in many countries (Kueh, Abdullah, Kuan, Morris, & Naing, 2018). Collaboration between researchers and schools are needed to provide PA to the participants once a day, in between or during class sessions.
A study by Glapa et al. (2018) investigated the effectiveness of brain breaks in changing attitudes towards PA among school children in Poland. A total of 326 participants aged 9 to 11 years old were recruited. They were randomly divided into experimental and control groups. Attitudes toward PA scale (APAS) was used as an assessment. The findings suggested that the program helps to improve self-efficacy on learning among school children. Another similar study by Popeska et al. (2018) also conducted brain breaks in Macedonia to examine its effects on school children’s attitudes and interest in PA participation. This study also found positive results on children’s attitudes for PA, motivations for PA as well as internalisation of movement habits as good personality.